Similar to what is occurring in other sectors of the U.S. economy, developments in technology already play a role in transforming the health care sphere. Artificial intelligence and virtual reality are expected to continue making significant inroads in health professions education and patient care. Another facet of technology that also attracts increased attention is patient wearables. The New England Journal of Medicine is one of many periodicals that has had a focus on this topic. A final review of a series on wearable digital health technologies (DHTs) appeared in the March 21, 2024 issue.
It highlights important challenges that must be met to integrate these devices into clinical guidelines and practice. The narrative deliberately is grounded in what is possible today, but speculations also are made about specific uses of wearable DHTs in the future. Six interlocking and vexing issues are identified as being at the foundation of delivering DHT-informed care. They are:
Data Ownership
Who owns the raw and derivative data obtained from wearable DHTs? Ownership can be unclear, since data collection involves multiple stakeholders, including patients, device manufacturers, app providers, and data aggregators.
Patient Trust, Literacy, and Access
Fear that personal health data may be compromised or misused, especially with the increasing use of AI, is one of the most important trust issues.
Standards and Interoperability
Although the broad field of DHTs, which includes electronic health records and telemedicine, has adopted data standards, the field of wearable DHTs, which is characterized by ongoing development, lacks such standards.
Integration into Clinical Environments
Integrating wearable DHTs into clinical care presents several workflow challenges that can affect both health care professionals and patients. One of the biggest challenges is the sheer volume of data generated by wearable DHTs, which can be overwhelming.
Patient Empowerment and Agency
For patients to have agency and empowerment in using data from their wearable DHTs, the challenges of control over the data, an understanding of how the data can be used effectively, and trust in the systems managing the data will need to be addressed.
Reimbursement and Return on Investment for Health Care Systems
A set of Current Procedural Terminology (CPT) codes exists for remote patient monitoring with wearables. Devices and procedures that do not meet existing CPT definitions still present serious challenges in securing reimbursement.
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